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Laboratory detection of complement activation and complement deficiencies.

The complement system is the major humoral amplification and effector mechanism of the immune system. Complement is activated in a variety of conditions, especially in immune-complex diseases. Activation can result in consumption of components involved in either the classical or the alternative complement pathway or both pathways. Such activation can be detected by laboratory analysis, quantitating specific complement component levels and measuring hemolytic function. An integrated approach to the laboratory evaluation of complement can ascertain which complement pathway is being activated, either in vivo or in vitro. Complement deficiency states are not rare, and a large enough number of such patients have now been detected for the patterns of disease susceptibility to be recognized. Since inherited deficiency of a complement protein may have dire consequences, it is important for laboratory technologists to recognize the patterns of reactivity associated with these deficiency states. The physician can then be alerted so that appropriate and effective preventive or therapeutic measures can be taken. In addition, the study of patients lacking an individual complement component has provided substantial understanding of the role of the complement system in host defense and inflammation.

Animals

A detailed genetic analysis of the late complementation groups of simian virus 40.

A simple mixed-plaque assay procedure for determining complementation between pairs of SV40 mutants is described. Since the data obtained can be quantified with respect to both the relative numbers and sizes of plaques, this method is less likely than other complementation assay procedures to yield false-positive results and gives some indication as to the efficiency of the complementation. This quantitative assay procedure, which works with both viral DNA and virions, was used to examine the complementation properties of a variety of late region temperature-sensitive and deletion mutants of SV40. Conclusions reached from these studies included (i) the complementation observed between tsB and tsC mutants is definitely intragenic; (ii) D mutants define a true complementation group; (iii) sequences within the last 68 carboxyl-terminal amino acids of VP-3 are necessary for expression of the D function; and (iv) when linked to the last 19 carboxyl-terminal amino acids of VP-1, the first 136 amino-terminal amino acids of VP-2 are sufficient for expression of the E function. Lastly, the collection of deletion mutants described here may be useful in identifying both structural and regulatory functions of the virion proteins and in analyzing some aspects of viral mRNA biogenesis.

Animals

Quantitative studies of the secretion of complement component C3 by resident, elicited and activated macrophages. Comparison with C2, C4 and lysosomal enzyme release.

To quantitate the secretion of complement component C3 by guinea pig peritoneal macrophages an enzyme-linked immunosorbent assay was developed. C3 secretion was studied in resident, elicited and activated macrophages and compared with release of hemolytically active C2 and C4, as well as the lysosomal enzyme beta-D-2-acetamido-2-deoxyglucosidase. Resident macrophages secreted about 6 ng C3/10(6) cells/h into culture supernatants over a period of 12 h. Corynebacterium parvum-activated cells were found to secrete 3 times that amount at nearly constant rates. There was a stepwise increase in secretion of functional C2 and C4 when comparing resident, elicited and activated macrophages; secretion was 2--4 times higher in activated than in resident cells.

Acetylglucosaminidase

Simple quantitative haemolytic microassay for determination of complement alternative pathway activation (AP50).

We describe here a simple, reliable and quantitative method to measure the alternative pathway (AP) dependent mode of complement activation for the lysis of rabbit erythrocytes. In the test the reciprocal of the plasma volume needed to destroy 50% of available rabbit erythrocytes is defined as the functional measure of this activity (AP50). The test was found to be highly reproducible both within and between assays with a coefficient of variation which was less than 5%. Sensitivity was also shown to be satisfactory and all of the plasma samples from the healthy blood donors which were tested could be assayed with precision. The specificity of the AP50 assay for AP complement activation was verified by the fact that a C4 affinity-depleted plasma gave an AP50 value within the normal range (52.8 U/ml) while a similar aliquot of the same plasma, affinity-depleted of factor B, gave an undetectable AP50 value (less than 10 U/ml). Furthermore, a sample was unable to lyse the target cells when heated to 50 degrees C or 56 degrees C, treatments which are known to destroy factor B and total haemolytic complement, respectively. To ensure inhibition of the classical pathway of activation. EGTA and MgCl2 were added during the assay. An advantage of this assay is that it is possible, using microplates, multipipettes and a spectrophotometer coupled to a computer, to semi-automate the procedure.

Animals

Functional bacterial opsonic activity of human amniotic fluid.

There are some data to suggest that amniotic fluid protects the fetus from invasion by pathogenic bacteria. To examine methods by which amniotic fluid may offer such protection, quantitative antibody, complement activity, and functional opsonic capacity were measured. Immunoglobulins were measured by laser nephelometry and total hemolytic complement was determined by radial diffusion; results suggested activity adequate for bactericidal capacity. The chemiluminescence assay was used to quantitate the functional interaction between polymorphonuclear leukocytes and E. coli, group B streptococci (GBS), or zymosan particles preopsonized with amniotic fluid obtained at different stages of gestation. Results were compared to those for normal serum. Data were analyzed by evaluation of the initial slope, area under the curve, and peak chemiluminescence response. Opsonic activity of amniotic fluid for E. coli and GBS was demonstrated, with E. coli showing greater reactivity (maximum = 15,000 to 25,000 cpm) than GBS (10,000 to 20,000 cpm). Specific, as well as nonspecific, opsonic activity was demonstrated by absorption of amniotic fluid with killed bacteria. Concentration of amniotic fluid did not result in an increase in chemiluminescent activity, which demonstrates that optimal opsonic activity already exists. The classical and alternate pathways of complement were assessed for E. coli and GBS. Preterm amniotic fluid did not differ in response from that of amniotic fluid obtained from term pregnancies. This study demonstrates that amniotic fluid can provide the fetus with protection from bacterial pathogens and delineates mechanisms for such protection.

Amniotic Fluid

Low ionic strength or chemical cross-linking of monomeric C3b increases its binding affinity to the human complement C3b receptor.

Quantitative studies of the interaction between a fragment of the third component of complement (C3b) and its receptor on human cells have been undertaken with a recently developed radioligand binding assay. Specific binding of fluid phase monomeric C3b was direct and saturable under low (mu = 0.0513) but not physiological (mu = 0.15) ionic strength. Dimeric C3b had a greater affinity for the C3b receptor at either ionic strength. Complexing of monomeric C3b with another protein (human IgG) did not result in increase in binding to human erythrocytes when compared with monomeric C3b alone. These data suggest that ionic forces are involved in C3b receptor-ligand interactions and that the stable C3b-receptor binding site is present in monomeric C3b. Furthermore they suggest that the greater affinity of dimeric or oligomeric C3b is a result of multimeric binding to preclustered C3b receptors. These findings provide an explanation for the relatively stable interaction of particle bound C3b and C3b receptor-bearing cells in the immune adherence reaction.

Chromatography, Gel

Complement origin determines lytic activity of antibodies to nucleated target cells. Comparison of common complement sources.

The effects of complement from different species of animals were measured in a variety of antibody assays by using 51Cr-labelled target cells. Sheep antibodies were measured in samples of lymph and serum obtained from animals immunised with allogeneic lymphocytes, transplanted with allogeneic kidney grafts, or immunised with mouse tumour cells. Mouse (C57BL) antibodies were measured after immunisation with allogeneic tumour (P815) or after transplantation of allogeneic thyroid grafts (BALB/c). Different species of complement gave quantitative and sometimes qualitative differences when used to assay the same samples of antibody. In all systems tested, rabbit complement caused lysis of target cells at low antibody concentration when guinea pig and rat complements gave negative results, in some antibody-target cell combinations sheep complement was as effective as rabbit complement in mediating lysis. The different complement sources showed no selective lytic affinity for either IgM or IgG1 antibody subclasses purified from immune sheep lymph. Lysis of P815 target cells occurred more quickly when mediated by rabbit or sheep complement than when mediated by guinea pig or rat complement. Complement-dependent lysis sometimes occurred in systems where antibody, target cells and complement were obtained from the same species.

Animals

Paroxysmal nocturnal hemoglobinuria erythrocytes are of two distinct types: positive or negative for acetylcholinesterase.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder. Erythrocytes isolated from PNH patients show increased sensitivity to complement and decreased acetylcholinesterase (AChE) activity. In this study, indirect immunofluorescence analysis of a monoclonal antibody specific for a surface epitope of human erythrocyte AChE is used to quantitate the content of this enzyme at the single-cell level. Flow-cytofluorimetric analysis of erythrocytes from normal donors indicates that all erythrocytes contain detectable levels of the surface epitope with a strong correlation between cell size and enzyme content. In contrast, erythrocytes from PNH patients show two distinct populations of erythrocytes; namely, those containing a normal content of AChE and a second population containing no detectable AChE. The AChE-negative population of cells is quantitatively complement-sensitive. These data support suggestions that PNH is a clonal disorder resulting in two distinct types of circulating erythrocytes. The abnormal clone produces cells that are both surface-AChE-negative and complement-sensitive. In addition, the method described provides an attractive alternative for the diagnosis and quantitative evaluation of abnormal erythrocytes in PNH patients.

Acetylcholinesterase

Complement effector mechanisms in health and disease.

Complement is an effector system able to mediate a number of biological activities in vitro and in vivo. Most familiar is the ability of the system to mediate the lytic destruction of numerous kinds of cells and pathogenic organisms including bacteria, viruses, and virus-infected cells. In addition, the complement system also activates neutrophils, monocytes, basophils, mast cells, and lymphocytes to perform specialized functions. While generally considered to be confined to the effector side of immune reactions, recent evidence indicates that the complement system also directly recognizes and is triggered by a number of bacteria and viruses as well as virus-infected cells in the absence of antibody. In such reactions, complement fulfills the recognition role normally associated with the antibody molecule or immune lymphocyte. The complement system may thus also function as a natural surveillance system operative prior to the induction of specific immunity. Involvement of the complement system in biological reactions has been ascertained by several techniques over the years. These include quantitation of individual complement components in human sera and demonstration of complement deposition in diseased tissues in human diseases and in experimental diseases in animals. Such techniques, however, have limitations in specificity and sensitivity. Assays which detect specific features of the complement activation process have become available in recent years. These tests detect the physical, chemical, or antigenic changes characteristic of the complement activation process. These assays are extremely specific and quantitative; furthermore, most are usable with samples from patients. Three general approaches have been utilized to develop such specific quantitative assays for complement activation. The first includes assays which quantitate activation-specific limited proteolysis of the complement components. The second type of assay includes tests which detect and quantitate new antigens or other activation-specific antigenic changes. The third category is represented by assays which detect and quantitate the protein-protein complexes characteristic of the activation process. Examples of tests presenting each of these approaches are given.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

Antibody-dependent cytotoxicity against Trypanosoma rhodesiense mediated through an alternative complement pathway.

A quantitative in vitro method was used to examine the role of classical and alternative pathways of complement activation in cytotoxicity against African trypanosomes by immune serum. This assay is based on the estimation of the extent of antibody-mediated cytotoxicity by measurement of inhibition of incorporation of [(3)H]leucine as an indicator of trypanosome metabolic integrity. To determine which pathway(s) is activated during cytotoxic events, complements sufficient in all components (C4S) and deficient in C4 (C4D) were used. Immune inhibition of [(3)H]leucine uptake by trypanosomes was observed in the presence of both complement sources. Treatment of C4S or C4D serum with cobra venom factor or disodium ethylenediaminetetraacetic acid abolished antibody-mediated cytotoxicity as well as immune hemolysis, thus suggesting the requirement for late-acting complement components. Ethyleneglycol-bis(beta-aminoethyl ether)-N,N-tetraacetic acid had no effect on inhibition of leucine incorporation, whereas immune hemolysis was inhibited, suggesting that cytotoxicity did not require C1 activation, a Ca(2+)-dependent event. The dependence of the cytotoxic process on Mg(2+) and not Ca(2+) ions and the fact that C4D guinea pig serum is fully active in trypanosome cytotoxicity indicate that an alternative pathway of complement activation is sufficient for activity.

Animals

Quantitation of the third component of complement on stored red cells.

By means of an automated anti-C3c consumption technic, we quantitated the molecules of the third component of human complement (containing the C3c fragment) that accumulate on red cells (RBCs) during liquid whole-blood storage. Calibrated C-3 sensitized zymosan particles ( ZyC3 ) were used as standards for bound C3. Although the dose-response curves of anti-C3c neutralization by ZyC3 and stored RBCs were similar, mathematical analysis showed that the shapes of these two sigmoidal curves were significantly different. This indicated that the large C3 molecules bound to stored RBCs differed antigenically from those bound to ZyC3 . Despite this difference, the former could be quantitated adequately by the automated anti-C3c consumption technic. Red cell-bound large C3 molecules were measured following various periods of storage at 4 degrees C of whole blood samples (n=102). An average of 48 molecules were detected on RBCs stored for 21 days. Statistical analysis of these data indicated that during storage at 4 degrees C there was a continuous accumulation of C3 on RBCs, followed by cleavage of C3c fragments. The degree of agglutination of stored RBCs with anti-C3c was proportional to the number of cell-bound large C3 molecules.

Blood Preservation

The alternate complement pathway in inflammatory bowel disease. Quantitation of the C3 proactivator (factor B) protein.

A component of the complement system's alternate pathway was investigated in ulcerative colitis and Crohn's disease. The mean C3PA (Factor B) titer in normals was 74 +/- 15%; in ulcerative colitis, 92 +/- 18%; and in Crohn's disease, 119+/- 24%. Significance was at the P less than 0.001 level when the mean values for the ulcerative colitis and the Crohn's disease groups were compared to normal subjects. Titers did not change significantly with exacerbation or amelioration of the diseases or when patient groups were analyzed according to the mode of treatment received.

Blood Proteins

Effect of corticosteroids on the human monocyte IgG and complement receptors.

A quantitative in vitro assay was employed to directly assess the effect of corticosteroids on the IgG and complement receptor function of human mononuclear phagocytic cells. In this system corticosteroids were solubilized with cholesterol-phospholipid sonicated dispersions before exposure to mononuclear cells. Solubilized corticosteroids at concentrations between 10(-4) and 10(-3) M inhibited both IgG and complement receptor activity in a dose-response fashion. Inhibition was dependent upon the time of interaction of the mononuclear cells with corticosteroids and was half-maximal by 15 min. The inhibitory effect at all concentrations of hydrocortisone was partially overcome by increasing the number of IgG molecules per erythrocyte. Hydrocortisone also inhibited the binding of erythrocytes coated with both IgG and C3, despite the fact that when both were on the erythrocyte surface a synergistic effect on binding to mononuclear cells was observed. At the steroid concentrations employed, the capacity of mononuclear cells to exclude trypan blue and to take up latex particles and neutral red was unaffected. Mineralocorticoids also inhibited receptor activity, but the sex hormones were less effective. These studies demonstrate an effect of steroid hormones on cell membrane receptor function, and they suggest that an inhibition of the recognition system for IgG and C3 in vivo may explain, in part, the effect of corticosteroids in man.

Adrenal Cortex Hormones

Quantitative evaluation of the terminal C5b-9 complement complex by ELISA in human atherosclerotic arteries.

A quantitative ELISA using monoclonal and polyclonal antibodies against neoantigens of the terminal C5b-9 complement complex was used to evaluate the presence of terminal complexes in 68 human arterial samples with or without atherosclerotic involvement. Plasma levels of SC5b-9 were directly compared with the corresponding levels eluted from the femoral arteries in six patients undergoing surgical procedures. The plasma concentration of SC5b-9 in these donors was in the range of 30-90 arbitrary units (AU)/ml, equivalent to 100-300 ng/ml SC5b-9 or 45-130 AU/100 mg plasma protein. All the arterial samples contained detectable amounts of C5b-9. The aortic normal and fatty streaks intimae presented a minimum mean value of 65 +/- 12 AU/100 mg total protein, in the range of normal plasma SC5b-9 levels. The corresponding media contained significantly higher amounts of terminal complexes (115 +/- 30 AU/100 mg protein). Markedly increased levels of C5b-9 were eluted from aortic intimal thickenings (350 +/- 100 AU/100 mg protein) and the corresponding media (300 +/- 53 AU/100 mg protein). Similar concentrations were found in aortic fibrous plaques (340 +/- 80 AU/100 mg protein). The observed correlation between C5b-9 levels and atherosclerotic alterations in arterial walls is suggestive of chronic complement activation with involvement of the terminal complement sequence at these sites. These processes may contribute to progression of the arteriosclerotic lesions.

Adult

Fixation of complement by anti-F(ab')2 antibodies or ssDNA when added to systemic lupus erythematosus sera.

A solid phase total hemolytic complement assay was used to quantitatively determine the % complement fixation by anti-F(ab')2 antibodies or ssDNA when added to serum from patients with systemic lupus erythematosus (SLE). Both autologous and homologous anti-F(ab')2 antibodies with demonstrated anti-anti-ssDNA activity fixed complement when added to SLE sera and normal human complement. Furthermore, comparable amounts of anti-F(ab')2 antibodies with minimal anti-anti-ssDNA activity fixed zero or minimal amounts of complement when added to the same lupus sera. When measured by the same assay with the same sera, ssDNA fixed greater amounts of complement than did comparable amounts of any of the anti-F(ab')2 antibodies.

Antibodies, Anti-Idiotypic